title: Use of indwelling pleural catheters for cardiogenic pleural effusions.
abstract: BACKGROUND
  Cardiogenic pleural effusions are rarely refractory to treatment of the underlying disease. Few options are available in these cases. Indwelling pleural catheter (IPC) insertion has been well described for the management of malignant pleural effusions. We present our experience with using IPCs for cardiogenic pleural effusion management.
  
  
  METHODS
  We prospectively constructed a cohort of patients who underwent IPC insertion for cardiogenic pleural effusions. Patients were carefully selected, and the IPCs were inserted as a palliative measure or while awaiting cardiac transplantation.
  
  
  RESULTS
  There were 43 IPCs inserted in 38 patients. Patients had significant dyspnea, with a mean baseline dyspnea index of 2.24 (95% CI, 1.53-2.94). There was significant improvement in dyspnea 2 weeks after IPC insertion, with a mean transitional dyspnea index of 6.19 (95% CI, 5.56-6.82). There was no occurrence of empyema. Pneumothorax, mostly ex vacuo, occurred in 11.6% of procedures but did not require further intervention. IPCs were removed in 18 patients (47.4%), and successful spontaneous pleurodesis occurred in 11 patients (29.0%) after a median of 66 days (interquartile range, 34-242 days). Patients who eventually had their catheters removed had better performance status (P = .008) and were less dyspneic (P = .005) at baseline and had longer survival (P &lt; .0001).
  
  
  CONCLUSIONS
  IPC insertion for cardiogenic pleural effusion is a feasible option in carefully selected patients. Further research is needed to confirm the results and to assess the impact of IPC insertion on the quality of life of these patients.
authors.affiliation: Université de Sherbrooke, Sherbrooke, QC; Hôpital Charles-LeMoyne, Greenfield Park, QC; Ottawa Hospital Research Institute, Ottawa, ON. Electronic address: nadim.srour@usherbrooke.ca.
authors.forename: Nadim
authors.initials: N
authors.lastname: Srour
authors.affiliation: Faculty of Medicine, University of Ottawa, Ottawa, ON; Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada.
authors.forename: Rajini
authors.initials: R
authors.lastname: Potechin
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, ON; Faculty of Medicine, University of Ottawa, Ottawa, ON; Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada.
authors.forename: Kayvan
authors.initials: K
authors.lastname: Amjadi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D008297:Male; D010996:Pleural Effusion / Q000209:etiology / Q000628:therapy*; D018700:Pleurodesis / Q000295:instrumentation*; D011446:Prospective Studies; D016896:Treatment Outcome